Society Must Rally to Fight Obesity

Weight of the Nation campaign aims to fix America's obesity problem.

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TUESDAY, May 8, 2012 (MedPage Today) — A society-wide approach is needed to solve the complex and "catastrophic" problem of obesity in the U.S., according to a report from the Institute of Medicine (IOM).

The report on obesity prevention offers five sweeping recommendations to rein in the nation's expanding waistlines, including daily physical activity and encouraging healthcare providers, insurers, and employers to incentivize healthy living.

"The costs [of obesity] have the potential to become catastrophic and unaffordable unless all sectors of society take the need for obesity prevention seriously and act responsibly," Daniel Glickman, MD, chair of the IOM's Committee on Accelerating Progress in Obesity Prevention, wrote in the 478-page report's preface.

According to a 2005 Medicare survey, the estimated annual cost of obesity-related illness was $190.2 billion from 2000 to 2005, nearly 21 percent of annual medical spending in the country.

The report is part of the massive "Weight of the Nation" public health campaign launched by the IOM, NIH, and CDC, which has been promoted at a 3-day conference of the same name in Washington and a documentary series produced by HBO.

The committee evaluated hundreds of strategies designed to prevent obesity and identified those that would "accelerate meaningful change on a societal level."

It acknowledged that major society-level changes are needed and that there are "no simple or single-pronged solutions."

The five major recommendations include:

Making physical activity an "integral and routine" part of daily life

Creating environments that make healthy foods and drinks an easy choice for consumers

Imparting public health messages that make the public want to exercise and eat right

Expanding the roles of healthcare providers, insurers, and employers in preventing obesity

Making schools the heart of obesity prevention

The specific recommendations that fall under each of these categories include developing environments that encourage physical activity; adopting policies that reduce overconsumption of sugar-sweetened beverages (such as a soda tax); and re-evaluating the relationship between U.S. agriculture policies and the American diet.

The report specifically asks healthcare providers to adopt standards-of-practice guidelines for the prevention, screening, diagnosis, and treatment of overweight and obesity. These would include elements such as routine screening of body mass index and obesity training for medical school students and nurses.

Doctors and nurses also need to serve as role models for their patients and provide leadership for obesity prevention efforts in their communities, the report said.

"Whether leaders are identified or self-identify, once awareness of the catastrophic nature of the obesity problem is understood and felt, and the need for diverse and numerous leaders is recognized, all will share the moment of saying to themselves, 'I can do something about this,'" the authors wrote.

Insurers and employers should develop initiatives that offer incentive to maintain a healthy lifestyle, the committee wrote. Schools should be the focal point of change, it added, by making sure students get at least 60 minutes of exercise every day and by implementing strong nutritional standards for all food sold in their cafeterias.

During yesterday's sessions at the Weight of the Nation conference, the CDC released new estimates that predict 42 percent of the population will be obese by 2030.

Michael Jacobson, executive director of the nutrition advocacy group Centers for Science in the Public Interest, said the report "provides an excellent blueprint for solving America's costly obesity problem."

The report was also lauded by the American Heart Association. In a statement, AHA CEO Nancy Brown said all five recommendations "must be pursued fervently if we as a nation are to triumph over obesity," adding that the organization "has long been committed to raising the public's awareness about the powerful link between obesity and cardiovascular disease."

But the Center for Consumer Freedom, a nonprofit group supported by restaurants and food vendors, called the report's endorsement of policies such as soda taxes and restaurant zoning laws "misguided." It cited a lone study showing that food prices and restaurant locations play a "miniscule" role in the obesity epidemic, and noted recent CDC data that show obesity rates are leveling off.

"The Institute of Medicine and other food nannies are no longer just calling for Americans to reduce their consumption of certain foods," J. Justin Wilson, a senior research analyst with the organization, said in a statement. "They're flatly arguing against consumers having any choice in their snacks and meals. It is arrogant and absurd to suggest that Americans are too stupid to make their own food choices."

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